National Provider Identifier [NPI]: |
1386804151 |
Last Name Of The Provider |
LOUIS |
First Name Of The Provider |
SUDAD |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
27555 MIDDLEBELT RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
FARMINGTON HILLS |
Zip Code Of The Provider |
483345011 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
1467 |
Number Of Medicare Beneficiaries |
546 |
Total Submitted Charge Amount |
271915 |
Total Medicare Allowed Amount |
187861.37 |
Total Medicare Payment Amount |
145873.7 |
Total Medicare Standardized Payment Amount |
139468.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
1467 |
Number Of Medicare Beneficiaries With Medical Services |
546 |
Total Medical Submitted Charge Amount |
271915 |
Total Medical Medicare Allowed Amount |
187861.37 |
Total Medical Medicare Payment Amount |
145873.7 |
Total Medical Medicare Standardized Payment Amount |
139468.24 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
163 |
Number Of Beneficiaries Age 75 to 84 |
148 |
Number Of Beneficiaries Age Greater 84 |
132 |
Number Of Female Beneficiaries |
318 |
Number Of Male Beneficiaries |
228 |
Number Of Non Hispanic White Beneficiaries |
326 |
Number Of Black or African American Beneficiaries |
203 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
409 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
137 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
42 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
59 |
Average HCC Risk Score Of Beneficiaries |
2.2807 |